When Can You Book an Assessment?
You can arrange a consultation for concerns such as:
- excessive or unwanted filler volume
- filler migration
- noticeable asymmetry or contour irregularity
- persistent fullness or swelling around the eyes
- a palpable nodule, firmness or localised swelling
- older filler placed over several treatment sessions
- filler that remains after previous dissolving treatment
You can also attend if you want to reduce existing filler or reconsider the overall volume and shape of a previously treated area.
When Should You Seek Urgent Medical Assessment?
New visual symptoms or neurological symptoms after filler injection require urgent medical assessment. Do not wait for a routine appointment or delay care while trying to contact the injector.
This includes reduced or blurred vision, loss of vision or a new neurological symptom.
Severe or increasing pain, marked blanching, mottled or purple skin, or another unusual colour change can also indicate a vascular complication. Contact the practitioner who performed the injection immediately; if prompt assessment is not available, seek urgent medical care.
What Happens at the First Consultation?
We first review your previous filler treatments and how the current problem developed.
During examination, we look at volume distribution, asymmetry, swelling, tenderness, palpable nodules and the condition of the surrounding tissues.
The aim is to clarify three things: what is causing the problem, what type of filler or tissue change may be present, and which treatment would actually address it.
A visible irregularity is not always caused by excess filler alone. Migration, swelling, inflammation and changes in the surrounding tissues can require different treatment strategies.
When Do We Use Ultrasound?
Ultrasound is used selectively rather than routinely for every filler-dissolving treatment.
It can be particularly useful when:
- the exact location or tissue layer of the filler is uncertain
- older filler has been placed across several anatomical layers
- the filler material is unknown
- there is a localised problem around the eye
- a nodule or defined swelling is present
- previous dissolving treatments have not produced the expected result
- a specific filler deposit needs to be targeted more precisely
For superficial facial anatomy and filler assessment, we use Clarius L15 and L20 linear ultrasound systems, selecting the probe according to the treatment area and imaging requirement.
Ultrasound can help define the distribution of filler and its relationship to surrounding tissues. When targeted treatment is appropriate, it can also help identify the area that needs to be treated more precisely.
How Do We Plan Hyaluronidase Treatment?
Hyaluronidase is used when the filler involved is based on hyaluronic acid.
The amount and distribution of filler, anatomical layer, treatment area, age of the filler and treatment goal all influence how the procedure is planned.
For a broad excess of volume, a larger area may need to be reduced. For a localised problem, treatment can instead be limited to the relevant area.
The treatment goal is matched to the problem identified; complete removal of every trace of filler is not always necessary.
Will One Session Be Enough?
Sometimes one treatment produces sufficient reduction. Older, denser, widely distributed or multilayer filler may require a staged approach.
After the initial treatment, we reassess the tissue response and any remaining filler before deciding whether another session is useful.
For older or more complex filler problems, treating the area in stages can provide more control than trying to reach the final result in a single session.
What If Hyaluronidase Is Not Enough?
We reassess what is actually causing the remaining problem.
Persistent fullness or irregularity may come from residual HA filler, but other possibilities include a different filler material, fibrotic tissue, an inflammatory nodule, a capsule-like structure or a fluid collection.
Non-HA fillers such as permanent or semi-permanent materials cannot simply be dissolved with hyaluronidase. Their management depends on the material and the problem present.
Depending on the examination and, when useful, imaging findings, other options may include aspiration, mechanical evacuation, drainage or surgical treatment.
These are not automatic next steps after hyaluronidase. Treatment changes when the underlying problem requires a different approach.
What Can You Expect After Hyaluronidase?
Temporary swelling, redness, tenderness or bruising can occur after treatment.
Reduction in filler may become noticeable early, but swelling during the first hours or days can temporarily obscure the true contour. The result becomes easier to judge as the swelling settles.
Allergic reactions are uncommon but possible. Rapid facial or tongue swelling, breathing difficulty or another severe allergic reaction requires urgent medical care.
The timing of follow-up depends on the extent of treatment and what we are trying to achieve.
When Can New Filler Be Considered?
We first allow the tissues to settle and the true volume distribution to become clearer.
At follow-up, we decide whether new filler is actually needed. If it is, the treatment area and volume can be reconsidered based on the new anatomy.
There is no single waiting period that applies to every patient. In some situations, leaving the area untreated for a period is the more appropriate next step.
What Will You Know Before You Leave?
By the end of the consultation, you should understand:
- what appears to be causing the problem
- whether hyaluronidase is appropriate
- whether ultrasound or another investigation would add useful information
- whether treatment can reasonably be performed that day
- whether a single treatment or staged approach is more likely
- what the next step will be if hyaluronidase is not the appropriate solution
Same-day treatment depends on the examination findings, any imaging required and the procedure being considered.
What Information Is Helpful Before Your Appointment?
If available, bring or send:
- the brand or product name of previous fillers
- approximate treatment dates
- the areas that were injected
- the approximate amount used
- details of previous dissolving treatments
- any previous reaction to hyaluronidase
- a history of significant bee or wasp sting allergy
- older photographs showing the area before or after previous filler treatments
Missing records do not prevent an assessment, but previous treatment information can make the clinical picture easier to interpret.
Book a Consultation
If you have unwanted filler, persistent swelling, asymmetry, a nodule or a previous dissolving treatment that did not give the expected result, you can arrange an initial consultation for filler assessment.